MEDICARE: JAMES A LOPEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1225961741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES A LOPEZ

Provider Business Mailing Address
First Line	:	148 S COLE RD
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83709-0932
Country	:	US
Telephone Number	:	208-683-8320
Fax Number	:	208-969-8380

Provider Business Practice Location Address
First Line	:	148 S COLE RD
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83709-0932
Country	:	US
Telephone Number	:	208-683-8320
Fax Number	:	208-969-8380

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “ JAMES A LOPEZ ” Practice Location

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